The OtoScan Ear Aeration Delivery System provides the control required in order to perform laser-assisted tympanic membrane fenestration or OtoLAM. The diameter of the laser beam can be precisely selected in incremental steps of 0.1 mm, which is related to the length of time the hole remains open. A miniature video otoscope, a fiber illumination bundle and the laser delivery system are integrated into the OtoScan system to share a unique optical axis for precise, safe, yet simple placement of the laser hole. Included in the system is a set of speculum types for infants, children and adults, with diameters ranging between 2.5-5.5 mm.